Employers of Diversity Nomination: Step 2

Please fill in the following form to complete your nomination process. If at any time you wish to save your answers and complete at a later time, click the Save and continue later button at the bottom of this form.

Please enter your Payment Confirmation Code to verify that you have paid the $200 nomination processing fee.(Required)

For national/international organizations, the following pertains to Atlantic Canada operations only

1. Organization name as you would like it to appear in the magazine, if you are selected as one of the winners(Required)

2. Street address of your Atlantic Canada head office

Mailing Address Street/P.O. Box(Required)

Mailing Address City/Town(Required)

Mailing Address Province(Required)

Mailing Address Postal Code(Required)

3. Mailing address of your Atlantic Canada head office location, if different from above

Civic Address Street/P.O. Box

Civic Address City/Town

Civic Address Province

Civic Address Postal Code

4. Person completing this application

Applicant's Name(Required)

Applicant's Title(Required)

Applicant's Phone Number(Required)

Applicant's Email(Required)

5. Media Relations Contact

Media Relations Contact Name

Media Relations Contact Title

Media Relations Contact Phone Number

Media Relations Contact Email

6. Social media
Please include your corporate social media handles for each of the following platforms

Facebook

Twitter

Instagram

7. In 25 words or less, what product/service does your company/organization provide?(Required)

8. In 25 words or less, why is Diversity and Inclusion one of your corporate values?(Required)

9. What percentage of your staff identifies as:

Staff: Male

Staff: Female

Staff: Nonbinary

Staff: Indigenous

Staff: Black

Staff: Person of colour

Staff: Immigrant

Staff: Person with disability

Staff: 2SLGBTQIA+

10. What percentage of your board identifies as:

Board: Male

Board: Female

Board: Nonbinary

Board: Indigenous

Board: Black

Board: Person of colour

Board: Immigrant

Board: Person with disability

Board: 2SLGBTQIA+

11. Do you have diversity and inclusion targets? If so, what are they?(Required)

12. How are you measuring those targets?(Required)

13. What are you doing to increase recruitment of underrepresented populations?(Required)

14. What, if any, health accommodations/supports do you offer?(Required)

15. What, if any, flexible work options do you offer?(Required)

16. Do you have formalized respectful workplace policies? If so, what are they and how do you ensure compliance?(Required)

17. What, if any, processes do you have in place to ensure pay equity?(Required)

18. Do you require your suppliers to have diversity and inclusion targets/policies?(Required)

19. What other programs/measures do you have in place to advance a diverse and inclusive culture?(Required)

20. Have diversity and inclusion helped your organization grow/prosper? If so, how?(Required)

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Employers of Diversity Nomination: Step 2

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